'Wholly inadequate'

From 2007 to 2009 there were about 900 confirmed new cases per year in Virginia of Lyme disease, an often painful and debilitating condition. With tick season coming soon, WORLD Virginia spoke with Dr. Samuel Shor, Associate Clinical Professor at George Washington University Health Care Sciences and a panel member of the Virginia Lyme Disease Task Force. Shor is also a noted critic of conventional medical wisdom regarding Lyme disease.

Why is Lyme so common in Virginia, especially northern Virginia?

There are several reasons; one, the lack of adequate education and recognition of risks by patients or physicians regarding prevention and what to do once they are ill; two, the increased incidence of infected ticks; and three, the increased risk of exposure to infected ticks.

What do people need to know about preventing the disease?

First, they need personal protection in their home-ecotone, or the periphery of their yard. They should disrupt the habitat by landscaping and remove weeds and create barriers [for the ticks]. They should also use granular insecticides. Second, avoidance is important. Third, they need personal protection, such as appropriate clothing (e.g. insect shield with permethrin), and self inspection.

What do people need to know about getting tested and treated for Lyme?

That there are two schools of thought with respect to "evidence based" guidelines: one represented by the Infectious Disease Society of America (IDSA) and the other by the International Lyme and Associated Disease Society (ILADS). Usually, when the IDSA provides guidelines relating to infections, the medical community bows to the expertise of this organization. It is their guidelines that are promoting this two-tiered system which involves a test called ELISA, which in the setting of a condition like HIV is very sensitive; however, it's less than 50% sensitive with Lyme disease. The second tier [is] the Western Blot test, but then there are many different types of Western Blots. The standard Western Blot that is run by the two most common labs Labcorp and Quest Diagnostics miss or do not catch for the most highly sensitive bands, which are 31 and 34. This is complicated by recommendations of treatment protocols that my research suggests is wholly inadequate.

The IDSA does not recognize chronic Lyme disease while the ILADS does; why do you think that most doctors, insurance companies, and government agencies are generally opposed to the theory of chronic Lyme?

It is unclear, but in part tied to the reliance on relatively insensitive tests and presentation with oftentimes symptoms that are very common: eg. Fatigue, headaches, pain, sleep issues.

Do you think most doctors in Virginia are learning how to effectively treat the disease, or are they still fairly uninformed?

Fairly uninformed. I truly believe the majority of physicians want the best for their patients, however, they've been provided a certain set of guidelines from an organization that they respect and find it hard to reconcile that this respected organization is promoting a set of guidelines that are flawed. It is folks like myself in an academic setting who are trying to do research and publish in a respected environment to try to convince your everyday family doctor who needs that information and doesn't have the time to be able to do it themselves.

What approaches do you take to combat the disease?

[I utilize] multiple options including form IV, or oral antibiotics as well as herbals.

What are some of the signals that should warn a person they have Lyme and should be tested?

Chronic fatigue, chronic pain-joint, legs/arms, headaches; fractured nonrestorative sleep.

How common is the bulls-eye rash?

Less than 50% of the time; and even if it occurs, it is not always identified if it is in a location the individual does not see.

What is the hardest thing for Lyme patients to deal with?

The chronicity of their disease and the lack of acceptance by many in the medical community along with insurance denials.

Is it possible to have a Lyme vaccination?

Theoretically. There is a bivalent vaccine available presently for dogs.

What are some of the things the Virginia Lyme Disease Task Force is doing to help Lyme patients?

Hopefully improving the education and recognition and acceptance of this condition.

Are things looking positive for the Task Force, or is it still an uphill fight?

I am cautiously optimistic. I think there is optimism in the potential, but as to what comes to fruition remains to be seen.